目的 探讨瘢痕或皮肤肿瘤切除后创面使用皮能快愈敷料（PELNAC，商品名：皮耐克）结合自体刃厚皮覆盖的治疗效果。 方法 回顾分析2010年1月－2013年1月收治的两组瘢痕或皮肤肿瘤切除术后创面分别使用不同皮片覆盖的治疗效果。A组6例，采用PELANC与自体刃厚皮片复合移植；B组10例，采用自体中厚皮片移植修复。随访近期、远期，对比评估两组创面存活的皮片外观，弹性；供皮区愈合情况。 结果 两组患者皮片完全成活，外观好，弹性佳，较术前明显改善。与B组相比，A组供皮区愈合时间短，愈合后色素沉着轻微，无明显疤痕形成。 结论 采用PELNAC与自身刃厚皮片复合移植修复瘢痕或肿瘤切除后创面，既能够显著改善外观、功能，达到理想的创面修复效果，又不会造成供皮区的继发性瘢痕增生，是一种理想的创面修复方式。
Objective To investigate the effect of the position of pancreatic duct in pancreatic section on postoperative pancreatic fistula. Methods The clinical data of patients undergoing pancreaticoduodenectomy admitted to the pancreatic surgery department of our hospital from September 2018 to August 2020 were retrospectively collected. The consistency between intraoperative pancreatic section data and preoperative CT cross-sectional images of pancreatic duct was compared, and the occurrence of postoperative pancreatic fistula was analyzed by univariate analysis and multivariate logistic regression model analysis, to determine whether the position of pancreatic duct on pancreatic section during pancreaticojejunostomy had an impact on the occurrence of postoperative pancreatic fistula. Results A total of 373 patients were included in this study. In 44 cases, the ratio of the thickness of the short distance from the center of the pancreatic duct to the edge of the pancreas at the pancreatic section was 0.41±0.09, and the imaging measurement value was 0.40±0.10. The interclass correlation coefficient detection value of the two measurement methods was 0.916 (>0.75), P<0.001, this had high consistency. Patients had a high BMI [OR=1.276, 95%CI (1.154, 1.411), P<0.000 1] and soft pancreatic texture [OR=2.771, 95%CI (1.558, 4.927), P=0.001] were independent risk factors for postoperative pancreatic fistula, while the risk of postoperative pancreatic fistula decreased with the increased proportion of pancreatic duct thickness from center to edge [OR=0.875, 95%CI (0.840, 0.911), P<0.000 1]. Conclusions Patients with high BMI and soft pancreas are independent risk factors for postoperative pancreatic fistula, and the risk of postoperative pancreatic fistula is reduced when the center of pancreatic duct is far from the edge of pancreas. The ratio of short distance from the center of pancreatic duct to the edge of pancreas to the total thickness of pancreas measured by preoperative imaging can be used to evaluate the risk of postoperative pancreatic fistula.